A 13-year-old obese boy presents with a limp and referred pain in the thigh. Hip radiographs show the line drawn along the superior margin of the femoral neck (Klein's line) failing to intersect the epiphysis of the left hip. The most likely diagnosis is:

• A Legg-Calve-Perthes disease
• B Transient synovitis of the hip
• C Developmental dysplasia of the hip
• D Slipped capital femoral epiphysis ✓

Explanation

Klein's line normally intersects the lateral portion of the capital femoral epiphysis. Failure of intersection means the epiphysis has slipped posteromedially, the radiographic hallmark of slipped capital femoral epiphysis, typically affecting overweight adolescents aged 10 to 16 years with groin or referred thigh and knee pain. Perthes disease shows fragmentation and flattening of the femoral head in a younger age group, and transient synovitis has normal radiographs.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.